The seroprevalence of anti-Histoplasma capsulatum IgG antibody among pulmonary tuberculosis patients in seven referral tuberculosis hospitals in Indonesia.

Autor: Kusmiati T; Department of Pulmonology, Soetomo Hospital, Surabaya, Indonesia., Burhan E; Department of Pulmonology, Persahabatan Hospital, Jakarta, Indonesia., Sugiyono RI; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Arlinda D; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Naysilla AM; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Wibisono BH; Department of Internal Medicine, Kariadi Hospital, Semarang, Indonesia., El Khair R; Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, Indonesia., Candrawati NW; Department of Pulmonology, Faculty of Medicine, Universitas Udayana, Prof. IGNG. Ngoerah General Hospital, Bali, Indonesia., Sinaga BYM; Department of Pulmonology and Respiratory Medicine, Adam Malik Hospital, Medan, Indonesia., Djaharrudin I; Department of Pulmonology, Faculty of Medicine, Universitas Hasanuddin, Wahidin Sudirohussodo Hospital, Makassar, Indonesia., Lokida D; Department of Clinical Pathology, Tangerang District Hospital, Banten, Indonesia., Kosasih H; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Susanto NH; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Butar Butar DP; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Adawiyah R; Department of Parasitology, Universitas Indonesia, Jakarta, Indonesia., Fatril AE; Department of Parasitology, Universitas Indonesia, Jakarta, Indonesia., Karyana M; Indonesia Clinical Research Center (INA-CRC), Health Policy Agency, Ministry of Health, Jakarta, Indonesia., Denning DW; Manchester Fungal Infection Group, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom., Wahyuningsih R; Department of Parasitology, Universitas Indonesia, Jakarta, Indonesia.; Department of Parasitology, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Sep 20; Vol. 17 (9), pp. e0011575. Date of Electronic Publication: 2023 Sep 20 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0011575
Abstrakt: Background: Histoplasma capsulatum exposure is rarely suspected in Indonesia. Pulmonary histoplasmosis can occur simultaneously with pulmonary tuberculosis (TB) or as an alternative diagnosis in clinically-diagnosed TB patients with no microbiological evidence of TB. This study aimed to determine the seroprevalence of anti-H. capsulatum IgG antibody among pulmonary TB patients.
Methodology: This was a sub-study of 306 participants from a prospective cohort pulmonary TB study conducted at seven TB referral hospitals in Indonesia. The study population was presumptive pulmonary TB adult patients who underwent microbiological TB examinations and were categorized as drug-sensitive (DS), drug-resistant (DR), and clinically-diagnosed TB. Anti-H. capsulatum IgG antibody levels at baseline were measured using MVista Histoplasma Ab enzyme immunoassays. Data were summarized using descriptive statistics. Bivariate and multivariate logistic regression analysis were performed to assess factors associated with anti-H. capsulatum IgG antibody positive result.
Results: 12.7% (39/306) of pulmonary TB patients were positive for anti-H. capsulatum IgG antibodies (DR-TB patients (15.9%, 18/114), DS-TB (13.0%, 15/115), and clinically-diagnosed TB (7.8%, 6/77)). The median unit value of anti-H. capsulatum IgG antibody for all positive samples was 15.7 (IQR 10.2-28.9) EU. This median unit value was higher in clinically-diagnosed TB patients compared to DS-TB or DR-TB patients (38.1 (IQR 25.6-46.6) EU, 19.7 (IQR 12.3-28.9) EU, and 10.9 (IQR 9.2-15.4), respectively). There were 10 patients (3.3%) with anti-H. capsulatum IgG antibody levels above 30 EU. Factors associated with the anti-H. capsulatum IgG antibody positive result were malignancies (OR 4.88, 95% CI 1.09-21.69, p = 0.037) and cavitary lesions (OR 2.27, 95% CI 1.09-4.70, p = 0.028).
Conclusions: Our results provide evidence of exposure to H. capsulatum among pulmonary TB patients in Indonesia. Further studies are needed to provide a comprehensive picture of this fungal disease in other populations and regions to enhance awareness among clinicians and public health officials.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Kusmiati et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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